JP2000197630A - Tomographic apparatus - Google Patents

Abstract

PROBLEM TO BE SOLVED: To a securely piercing route for piercing a bioptic needle for a biopsy and an injecting needle for injecting medicine to an examinee. SOLUTION: This tomographic apparatus is constituted to automatically and collectively display a guide line GL connecting both of the bioptic needle piercing point A and a tissue collecting point B of the examinee M, an intersection mark MP showing the intersection of the guide line GL and a CT tomographic image and angles AG1, AG2 and a length D making the criteria of the piercing direction/depth of the bioptic needle on a display monitor at the time of designating and inputting the point A and the point B on the screen of the monitor 16. Since what an operator should do is only piercing the bioptic needle to a depth shown by the length D along the guide line GL and the mark MP in a direction shown by the displayed angles AG1, AG2, he can speedily pierce the bioptic needle or the injection needle to the examinee along the secure piercing route.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a method for inserting a biopsy needle into a subject for collecting a tissue for biopsy (biopsy test) from the body of the subject, and for controlling or controlling an affected part in the subject. The present invention relates to a tomography apparatus such as an X-ray CT apparatus and an MRI apparatus used when inserting an injection needle for administering a substance into a subject, and particularly relates to a biopsy needle and an injection needle (hereinafter, collectively referred to as these needles. The present invention relates to a technique for predicting an insertion path of an “insertion needle”.

[0002]

2. Description of the Related Art At medical institutions, it is practiced to insert a puncture needle into the body of a subject to obtain a biopsy tissue for cancer examination or treatment, or to administer an anti-cancer drug or the like to an affected part. Conventionally, as one of the insertion methods of the insertion needle, for example, there is a method of inserting the insertion needle while monitoring the insertion state of the needle under X-ray fluoroscopy using an X-ray CT apparatus. Hereinafter, a biopsy needle will be described as an example.

In this method, as shown in FIG. 15, an X-ray tube (not shown) is applied to a cross section (slice plane) D1 where a biopsy needle insertion point A in a subject M on a top 50 is present. And a tomographic image P1 of a cross section D1 is obtained based on X-ray detection data output from an X-ray detector (not shown), and a display monitor is provided as shown in FIG. It is projected on the screen of 51 in real time.

[0004] Then, the biopsy needle K is applied to the biopsy needle insertion point A on the body surface of the subject M, and the biopsy needle K is gradually moved to the tissue sampling point B with reference while watching the screen of the display monitor 51. At the same time as inserting, the top plate 50 is moved to change the cross section irradiated with the fan beam FB from the cross section D1 where the biopsy needle insertion point A exists to the cross section Dn where the tissue sampling point (target point) B exists. To change in order.

[0005] Then, the tomographic images displayed on the screen of the display monitor 51 change sequentially, and the tomographic images shown in FIG.
As shown in the figure, the screen of the display monitor 51 displays the tomographic image Pm.
At the same time, the needle tip Ka of the biopsy needle K appears, so that the surgeon can continue the insertion of the biopsy needle K while constantly monitoring the state of insertion of the biopsy needle K on the screen of the display monitor 51.

Thus, as shown in FIG. 16C, when it is confirmed that the tip Ka of the biopsy needle K has reached the position of the tissue sampling point B of the tomographic image Pn of the cross section Dn of the subject M. Thus, the insertion of the biopsy needle K is completed.

[0007]

However, when a biopsy needle is inserted using a conventional X-ray CT apparatus or the like, the insertion path of the biopsy needle is not very accurate, and the biopsy needle is not easily inserted. Is very time-consuming. The surgeon inserts the biopsy needle K by predicting the insertion path of the biopsy needle K by looking only at the tomographic image of the cross section of the subject M, but only by using each tomographic image of the cross section of the subject M. It is difficult to accurately predict the insertion path of the biopsy needle K. Thus, if the prediction of the insertion path of the biopsy needle K is inaccurate, the insertion path of the biopsy needle K will not be accurate. In addition, between the biopsy needle insertion point A and the tissue sampling point B, there are some organs that do not need to pass through the needle and hard bones that do not pass through the needle, and the necessary organs and hard bones are removed by trial and error. While the biopsy needle K
Therefore, it takes a long time to insert the biopsy needle.

SUMMARY OF THE INVENTION In view of the above circumstances, it is an object of the present invention to provide a tomographic imaging apparatus capable of providing an accurate insertion path for an insertion needle and quickly inserting the insertion needle.

[0009]

According to a first aspect of the present invention, there is provided a tomographic imaging apparatus, wherein a tomographic image of a puncture site of a puncture needle in a subject is displayed on a display monitor in real time. In the tomography apparatus configured to be configured such that the insertion point and the target point of the insertion needle in the subject are designated and input on the screen of the display monitor on which the tomographic image is projected, and screen input means. It is provided with a guideline obtaining and displaying means for obtaining a line segment connecting the designated insertion point and the target point and superimposing and displaying the obtained line segment on the tomographic image as a guideline when inserting the insertion needle. .

According to a second aspect of the present invention, in the tomography apparatus according to the first aspect, an intersection between the tomographic image and the guide line is sequentially obtained by following the positional displacement of the tomographic image, and the obtained intersection is determined. Intersection finding display means for superimposing and displaying the intersection mark shown on the tomographic image.

According to a third aspect of the present invention, in the tomographic apparatus according to the first or second aspect, the slice width areas corresponding to both ends of the guide line existing within the slice thickness width of the tomographic image are located at the position of the tomographic image. A slice width area obtaining and displaying means is provided for sequentially obtaining the guide line following the displacement and superimposing and displaying the obtained slice width area of the guide line on the tomographic image.

Further, the invention of claim 4 provides the invention according to claims 1 to 3
In the tomography apparatus according to any one of the above, an angle between the guide line and a preset reference axis is calculated, and a numerical value indicating the calculated angle is simultaneously displayed on a display monitor for displaying a tomographic image. Output display means.

Further, the invention of claim 5 provides the invention according to claims 1 to 4
In the tomographic apparatus according to any one of the above, the length of the guide line is calculated, and a length calculation display unit for simultaneously displaying a numerical value indicating the calculated length on a display monitor for displaying a tomographic image is provided. I have.

[Operation] Next, the operation when the insertion needle is pierced into the subject using the tomography apparatus of the present invention will be described.
In the case where the insertion needle is inserted into the subject using the tomography apparatus according to claim 1, a tomographic image in which the insertion point or the target point of the insertion needle is present on the subject is displayed on a display monitor, and screen input is performed. By means, the insertion point and target point of the insertion needle in the subject are designated and input on the screen. In the case of the tomography apparatus according to the first aspect, when the designation of the insertion point and the target point is performed, a line segment connecting the insertion point and the target point is immediately obtained by the guideline obtaining and displaying means. The outgoing line segment is automatically superimposed and displayed on the tomographic image as a guideline when piercing the puncture needle.

In this way, based on the guideline superimposed on the tomographic image on the screen of the display monitor, the operator
The suitability of the insertion path of the insertion needle is immediately determined, and if it is determined to be appropriate, the operator simply inserts the insertion needle according to the guidelines. That is, in the case of the device of the present invention, the guideline is a guide when the puncture needle is inserted. If the insertion route is determined to be inappropriate,
The specification of the insertion point or the target point of the insertion needle is redone, and the guideline is calculated and displayed again.

In the tomographic imaging apparatus according to the second aspect, the intersection between the tomographic image to be displayed and the guide line is sequentially determined by the intersection determining and displaying means following the positional displacement of the tomographic image and indicates the determined intersection. The intersection mark is superimposed on the tomographic image. If the insertion needle is correctly inserted according to the guidelines, the surgeon must use the needle tip of the insertion needle because the needle tip of the insertion needle must naturally always coincide with the seek intersection. Is inserted so as to always match the intersection mark indicating the calculated intersection. In other words, the intersection mark indicating the calculated intersection is a guide for guiding the needle point of the insertion needle to an accurate position.

In the tomographic imaging apparatus according to the third aspect, the slice width areas corresponding to both ends of the guide line existing within the slice thickness width of the tomographic image follow the positional displacement of the tomographic image by the slice width area calculating and displaying means. And the slice width area of the determined guideline is superimposed and displayed on the tomographic image, so that the surgeon makes sure that the tip of the puncture needle is exactly between the start and end of the guideline slice width area. Perform the insertion operation to move the. In other words, each tomographic image superimposed and displayed on the guideline has a form in which the data within each slice thickness width of the subject is added and compressed into a single image, and the puncture needle is strictly based on the guideline. When the operator performs the insertion operation correctly based on each tomographic image, the insertion point of the insertion needle is exactly from the start of the slice width area of the guideline. This is because it moves to the end. Therefore, the slice width area of the guide line superimposed and displayed on the tomographic image is a guide for guiding the needle tip of the insertion needle to an accurate position over the entire width of the slice thickness.

In the tomography apparatus according to the fourth aspect, the angle between the guide line and the preset reference axis is determined by the angle determining and displaying means, and the numerical value indicating the determined angle is used for displaying a tomographic image. Displayed simultaneously on the display monitor. Since the numerical value indicating the angle between the guideline and the reference axis corresponds to the insertion direction of the insertion needle, the operator determines the insertion direction of the insertion needle from the numerical value indicating the calculated angle on the display monitor screen. Can be easily grasped. That is, the numerical value indicating the calculated angle is a measure of the direction in which the insertion needle is inserted.

In the tomographic apparatus according to the fifth aspect, the length of the guide line is determined by the length determining and displaying means, and a numerical value indicating the determined length is simultaneously displayed on a display monitor for displaying a tomographic image. You. Since the length of the guide line corresponds to the insertion depth of the insertion needle, the surgeon can easily grasp the insertion amount of the insertion needle from the numerical value indicating the guide line length on the display monitor screen. . That is, the numerical value indicating the length of the guideline is a measure of the amount of insertion of the insertion needle.

[0020]

Next, an embodiment of the present invention will be described with reference to the drawings. FIG. 1 is a block diagram showing an overall configuration of an X-ray CT apparatus which is an example of a tomographic apparatus according to the present invention. In the following, a case will be described in which a biopsy needle is inserted into a subject. However, the present invention can also be applied to a case in which an injection needle for administering an anticancer drug to an affected part in the subject is inserted into the subject. it can.

As shown in FIG. 1, the X-ray CT apparatus of the embodiment includes a movable top plate 1, an X-ray tube 2 for X-ray irradiation, and a transmission X-ray tube.
An X-ray detector 3 for detecting X-rays, and an imaging system arranged so as to face each other across the subject M.
An imaging system rotation drive unit 4 is provided for rotating the X-ray detector 3 around the body axis of the subject M in the direction indicated by the arrow RA while keeping the X-ray detector 2 and the X-ray detector 3 facing each other.

The top board 1 is configured to be movable in the front-rear direction while the subject M is placed thereon. The movement of the top 1 is performed under the control of the top driving unit 5. During rotation, the X-ray tube 2 is configured to irradiate the subject M with the fan beam FB according to set irradiation conditions such as a tube voltage and a tube current under the control of the irradiation control unit 6 including a high voltage generator and the like. .

The X-ray detector 3 is a multi-channel detector in which a very large number of about 1000 X-ray detection elements 3a are arranged along the spread of the fan beam FB.
The X-ray detector 3 that rotates together with the X-ray tube 2 outputs X-ray detection data in accordance with the irradiation of the fan beam FB from the X-ray tube 2.

The imaging system of the embodiment includes a rotating ring 7 to which the X-ray tube 2 and the X-ray detector 3 are fixed, and a pulley 8a.
And a ring rotating mechanism 8 composed of a belt 8b and the X-ray tube 2 and the X-ray detector 3 as the ring rotating mechanism 8 rotates the rotating ring 7 under the control of the imaging system rotation driving unit 4. Are linked to rotate. The control by the imaging system rotation drive unit 4, the top plate drive unit 5, or the irradiation control unit 6 is as follows.
A photographing control unit 10 in accordance with an input operation or the like from a console 9 or the like.
This is performed in accordance with a command signal that is sent from the computer in a timely manner.

In the case of the embodiment apparatus, the X-ray detection data output from the X-ray detector 3 accompanying the irradiation of the fan beam FB by the X-ray tube 2 is transmitted to a data acquisition unit (DAS) 11.
After that, the data is sent to the AD converter 12 which digitizes the data. Further, after the AD converter 12,
A detection data memory 13 for storing X-ray detection data, an image reconstruction unit 14 for performing a three-dimensional image reconstruction process based on the X-ray detection data, and a CT tomographic image for temporarily storing a created (X-ray) CT tomographic image In addition to the image memory 15, a display monitor 16 for displaying a CT tomographic image on a screen is provided.

In the imaging system of the embodiment, FIGS.
As shown in (1), XYZ orthogonal coordinates having the image pickup center in the gantry G as the origin C are set as device coordinates. When X-ray imaging of the subject M is performed, the subject M is placed on the top 1 so that the body axis of the subject M is aligned with the Z axis, and then the fan beam FB is moved to the origin as shown in FIG. As a result of the irradiation at the position C in conformity with the XY plane, a CT tomographic image of the cross section of the subject M that coincides with the XY plane is obtained. It should be noted that although the gantry G may actually be tomographically photographed with the gantry G tilted by a set angle, a case where the tomographic image coincides with the XY plane will be described here for easy understanding.

Therefore, as shown in FIG. 3, the top board 1 is moved along the Z-axis direction indicated by the arrow RB, and, for example, the respective Z coordinates Z1,.
.. are adjusted to the position of the origin C, arbitrary cross sections D1,... D of the subject M (perpendicular to the body axis) are obtained.
n,... CT tomographic images can be obtained one after another. Note that the center of the screen coordinates of the display monitor 16 that displays the CT tomographic image is also associated with the origin C of the device coordinates.

The X-ray CT apparatus according to the embodiment has various characteristic configurations useful for using a biopsy needle for collecting a biopsy tissue from the inside of the subject when piercing the subject M. . In other words, the apparatus of the embodiment uses a mouse (screen input means) for designating and inputting the biopsy needle insertion point A and the tissue sampling point (target point) B in the subject M on the screen of the display monitor 16 on which the CT tomographic image is projected. ) 17 and
A line segment connecting the biopsy needle insertion point A and the tissue sampling point B designated and input with the mouse 17 is determined, and the determined line segment is superimposed and displayed on the CT tomographic image as a guideline GL for inserting the biopsy needle. And a guideline request display unit 18. Here, as shown in FIGS. 2 and 3, the biopsy needle insertion point A is located at the outer edge of the cross section D1 of the current Z coordinate Z1, and the tissue sampling point B is the cross section Dn of the current Z coordinate Zn. It is assumed to be near the middle of

When inputting the biopsy needle insertion point A on the screen, the CT tomographic image of the cross section D1 is projected on the screen of the display monitor 16 as shown in FIG. Click at the position of biopsy needle insertion point A. Then, the photographing control unit 10 causes the display monitor 1
The X and Y coordinates (X1, Y1) (corresponding to the device coordinate system) of the biopsy needle insertion point A are read from the screen input point on the screen of No. 6 and the origin sent by the top position detecting unit 19. The Z coordinate (Z1) (corresponding to the device coordinate system) of the biopsy needle insertion point A is read from the amount of movement of the top board 1 from C. The read three coordinates of the biopsy needle insertion point A are sent to the guideline request display unit 18.

When inputting the tissue sampling point B on the screen, FIG.
As shown in the figure, the CT tomographic image of the cross section Dn is projected on the screen of the display monitor 16, and the mouse 17 is operated to move the cursor to the position of the tissue sampling point B and click. Then, the X and Y coordinates (Xn, Yn) (corresponding to the apparatus coordinate system) of the tissue sampling point B are read from the screen input point on the screen of the display monitor 16 by the imaging control unit 10, and the top plate position is detected. The Z coordinate (Zn) (corresponding to the device coordinate system) of the tissue sampling point B is read from the movement amount of the top 1 from the origin C sent by the unit 19. The read three coordinates of the tissue sampling point B are the guideline calculation display unit 1
8 is sent.

On the other hand, in the guideline request display section 18,
The guideline GL is immediately calculated based on the coordinates of the two points A and B, and the guideline GL is displayed on the screen of the display monitor 16 in a form superimposed on the CT tomographic image, as shown in FIG. FIG. 6 shows a CT tomographic image of the cross section Dm. The surgeon is a guideline GL
Is used as a guide for the insertion path of the biopsy needle. Although the guide line GL connecting the points A and B is usually a straight line in a three-dimensional coordinate system, the tomographic image on the display monitor 16 displays the two-dimensional guide line GL projected on the slice section.

Further, the apparatus of the embodiment sequentially finds the intersection of the slice section to be photographed and the three-dimensional guide line GL following the movement of the top 1 and, as shown in FIG. An intersection finding display section 20 is provided for superimposing and displaying an intersection mark MP indicating a found intersection on a CT tomographic image. If the points A and B are not on the same cross section, the slice section of the imaging target and the guideline GL only intersect at one point,
When the position of the intersection changes with the position of the slice section (cross section) of the imaging target, the position of the intersection with the guide line GL changes. Therefore, the position of the intersection follows the movement of the top 1 (the position of the cross section at the origin C). They need to be determined sequentially (following changes). As shown in FIG. 7, when inserting the biopsy needle K, the needle point Ka is set to match the intersection mark MP. Since the fan beam FB has a certain thickness, a part of the biopsy needle K
It appears in the tomographic image.

Further, in the apparatus of the embodiment, the guideline G
An angle AG1 between the L axis and the Z axis (reference axis) and an angle AG2 between the guideline GL and the Y axis (reference axis) are calculated by calculation, and numerical values indicating the calculated angles AG1 and AG2 are shown in FIG. As described above, the angle calculation display unit 21 that simultaneously displays the data on the display monitor 16, the length D of the guide line GL is calculated by calculation, and the numerical value indicating the calculation length D is:
As shown in FIG. 6, a length calculating and displaying unit 22 for simultaneously displaying on the display monitor 16 is provided.

The operator can determine the insertion direction of the biopsy needle K from the numerical values of the angles of determination AG1 and AG2.
For example, when the surgeon vertically aligns the biopsy needle K with the biopsy needle insertion point A, and then tilts the Z-axis by the calculated angle AG1 and then tilts the Y-axis by the calculated angle AG2, The biopsy needle K will point in the same direction as the guideline GL.

Further, the operator can estimate the insertion depth of the biopsy needle K from the numerical value of the calculated length D. usually,
Since the scale is engraved from the needle tip to the base of the biopsy needle K, the biopsy needle K is inserted into the scale corresponding to the numerical value of the calculated length D.

In the case of the X-ray CT apparatus according to the embodiment, as described above, not only the cross section perpendicular to the body axis of the subject M is photographed but also the gantry tilt drive unit 5a as shown in FIG. Then, the gantry G is tilted by the angle TA,
In some cases, a cross section obliquely inclined with respect to the body axis of the subject is set as a slice plane to be imaged. In this case, guideline G
L, the intersection of the guide line GL and the CT tomographic image, or the calculated angles AG1, A indicating the direction of the guide line GL
When obtaining the length D of the guideline G2 and the guideline GL, it is necessary to consider the inclination angle TA of the gantry G. In the case of the embodiment, an inclination angle detection unit 23 for detecting the inclination angle TA of the gantry G is provided.
The inclination angle TA is sent to 20 to 22, and a process of replacing each coordinate with the device coordinate system based on the inclination angle TA is performed in each calculation display unit. Also,
In the case of the embodiment device, the image reconstruction unit 14 and each of the calculation display units 1
Reference numerals 8, 20 to 22 mainly configure a computer and its operation program (software).

Next, the operation of the apparatus when the biopsy needle is inserted into the subject M and the tissue is collected under CT fluoroscopy using the apparatus having the above-described configuration will be described with reference to the drawings. . FIG. 9 is a flowchart showing the progress of tissue collection performed using a biopsy needle.

[Step S1] The subject M from which the tissue for biopsy is to be collected is placed on the top 1 and irradiated with the fan beam FB while moving in the Z-axis direction.
Is displayed on the display monitor 16 at a high rate of, for example, 8 images / 1 second, and CT fluoroscopy is started.

[Step S2] As shown in FIG. 4, when the CT tomographic image of the cross section D1 having the biopsy needle insertion point A is displayed on the screen of the display monitor 16, the top plate 1 is temporarily moved. After stopping and clicking the biopsy needle insertion point A by operating the mouse 17, the top board 1 is moved again.

[Step S3] As shown in FIG. 5, when the CT tomographic image of the cross section Dn including the tissue sampling point B is displayed on the screen of the display monitor 16, the movement of the top 1 is temporarily stopped. The tissue sampling point B is clicked and input by operating the mouse 17.

[Step S4] Along with the designation of both points A and B, the guideline GL, the intersection mark MP, and the length D of the guideline GL are displayed on the screen of the display monitor 16 at the calculated angles AG1 and AG2. You.

[Step S5] Move the top plate 1 to C
The position of the T tomographic image is returned to the position displayed on the screen of the display monitor 16, and insertion of the biopsy needle K is started using the determined angles AG1 and AG2 as a guide.

[Step S6] As shown in FIG. 7, the tip Ka of the biopsy needle K is displayed at the intersection mark M on the screen of the display monitor 16.
If it matches P, the top board 1 is slightly moved.

[Step S7] Using the numerical value of the determined length D of the guideline GL as a guide, the step 6 is repeated until the tip Ka of the biopsy needle K reaches the tissue sampling point B. If the needle tip Ka of the biopsy needle K reaches the tissue sampling point B, step S8
Proceed to.

[Step S8] A procedure necessary for collecting a tissue for a biopsy test is performed.

[Step S9] After the necessary treatment for tissue collection is completed, the biopsy needle K is immediately pulled out and CT fluoroscopy is stopped in a timely manner.

[Step S10] When the subject M is dropped from the top 1, the tissue sampling for biopsy is completed.

According to the X-ray CT apparatus of the embodiment described above, the operator displays on the screen of the display monitor 16 the guide line GL connecting the biopsy needle insertion point A and the tissue sampling point B with the CT tomographic image. Is superimposed and displayed, so that the insertion path of the biopsy needle K can be accurately predicted and the insertion path of the biopsy needle K is always accurate, and the guideline GL serves as a guide when inserting the biopsy needle. The biopsy needle K can be quickly inserted.

Further, according to the apparatus of the embodiment, the intersection mark MP serving as a guide for guiding the needle point Ka to an accurate position is detected by the CT.
Since the display is superimposed on the tomographic image, the operator can more accurately and quickly pierce the biopsy needle K into the subject M.

Furthermore, according to the apparatus of the embodiment, the angles of determination AG1, AG2, which are indications of the insertion direction of the biopsy needle K,
Guideline GL as a guide for insertion depth of biopsy needle K
Is also displayed on the display monitor 16, so that the operator can
The biopsy needle K can be more accurately and quickly inserted into the subject M.

Next, another embodiment of the tomography apparatus according to the present invention will be described with reference to the drawings. FIG. 10 is a block diagram showing the overall configuration of an X-ray CT apparatus according to another embodiment. As shown in FIG. 10, the X-ray CT apparatus of this embodiment has the same configuration as that of the previous embodiment except that the X-ray CT apparatus includes a slice width area calculation display 24 in addition to the configuration of the previous embodiment. Since the device has an effect, only different points will be described to avoid duplication of description, and description of common points will be omitted.

That is, in the apparatus of this embodiment, as shown in FIG.
The slice width area existing within the slice thickness width of the T tomographic image is sequentially determined following the movement of the top board, and the area marks SPa and SPb indicating the slice width area of the determined guideline GL are added to the CT tomographic image. A slice width area calculation display section 24 for superimposed display is provided.

That is, in the case of an X-ray CT apparatus, strictly speaking,
As shown in FIG. 12, the CT tomographic image of each cross section (slice section) D1,... Dm, Dn at the position of each Z coordinate Z1,. The data in each slice thickness width Zd having a width of the equal distance ΔZ on both sides in the Z-axis direction with respect to the Z coordinate are Z coordinate Z1,.
It is added at the position of Zn (in the Z direction) and compressed into a single image, so to speak, so that the biopsy needle is pierced strictly according to the guideline GL by the slice thickness width. Here, taking the slice section Dm as an example, the intersection mark MP shown in FIG. 11 is the intersection point between the guide line GL and the slice section Dm in FIG. On the other hand, the area marks SPa, SPb shown in FIG.
Is a point obtained by projecting, on the slice cross section Dm, an intersection where _two opposing surfaces Dm ₁ and Dm ₂ that face each other at a distance corresponding to the slice thickness with the slice cross section Dm interposed intersect the guide line GL. Therefore, the intersection mark MP is, strictly speaking, both area marks SPa, SPb
Will be the midpoint of

More specifically, the slice width area calculation display unit 2
Reference numeral 4 denotes the position of the area marks SPa and SPb indicating the slice width area of the guideline GL and the dimension of the slice thickness width Zd input from the console 9 (for example, about 10 mm).
And the biopsy needle insertion point A and the tissue sampling point B input by the mouse 17 are obtained. For example, in the case of a CT tomographic image of a slice cross section Dm, the slice width area calculation display unit 24 displays an XY plane perpendicular to the Z axis at a position of a straight line connecting both points A and B and a Z coordinate (Zm-Zd / 2). Calculates the intersection with the (Dm ₁ plane) and the straight line connecting both points A and B and the XY plane (Dm ₂ plane) perpendicular to the Z axis at the position of the Z coordinate (Zm + Zd / 2). Then, each point obtained by projecting these two intersections on the slice section is displayed on the display monitor 16 as area marks SPa and SPb. For CT tomographic images of other slice sections, Z
It is calculated in a similar manner only by changing the coordinates Zm to the corresponding coordinates.

The configuration of the slice width area calculating and displaying unit is the same as the guideline G for the X, Y, and Z axes in addition to the above.
The inclination angle of L is obtained, the guide line GL is directed to both sides of the intersection MP, and the point advanced by half the slice thickness width Zd (= Zd / 2) by the distance corrected according to the inclination angle of the guide line GL is defined as: The configuration may be such that the position is determined as the position of the area mark SPa and the area mark SPb.

If the area marks SPa and SPb are superimposed and displayed on the tomographic image by the slice width area calculating and displaying section 24, this guides the needle point Ka of the biopsy needle K to an accurate position over the entire width of the slice thickness. It will be an indication of FIG.
As shown by a solid line, when the biopsy needle K is inserted in conformity with the guideline GL over the entire width of the slice thickness, the needle is displayed on the screen of the display monitor 16 as shown in FIG. The destination Ka just starts to appear at the position of the area mark SPa and reaches the area mark SPb exactly. Therefore, the operator only has to perform the insertion operation such that the tip Ka of the biopsy needle K moves exactly from the start end to the end of the guideline slice width area.

On the other hand, usually, the biopsy needle K conforms to the guideline GL.
If the biopsy needle K deviates from the guideline GL on the screen of the display monitor 16, even if the biopsy needle K deviates from the guideline GL, depending on how the biopsy needle K comes off, the biopsy needle K and the guideline Ka may be displaced. In some cases, the GL and the GL overlap (appearingly coincide with each other) and appear as a single line.
That is, the three-dimensional guideline GL is superimposed and displayed on the CT tomographic image in a form projected onto the slice section in a two-dimensional manner. If it comes off, CT
On the tomographic image, the tip Ka of the biopsy needle K and the guideline GL
And overlap. However, when the area marks SPa and SPb are displayed as in the X-ray CT apparatus of this embodiment, the needle point Ka does not actually match the guideline GL but only apparently matches. I understand.

That is, as shown by the dashed line in FIG. 13, the biopsy needle K deviates from the guide line GL to the left side in FIG. 13, but the biopsy needle K and the guide line GL only seemingly match. Display monitor 16
As shown in FIG. 14 (b), the needle point Ka starts to appear before the area mark SPa, and the area mark SPb
Can be reached only before the biopsy needle K
Can be recognized as not being stabbed correctly according to the guideline GL. Although the biopsy needle K deviates from the guide line GL to the right in FIG. 13 as indicated by the two-dot chain line in FIG.
When L coincides only with the appearance, the needle tip K is displayed on the screen of the display monitor 16 as shown in FIG.
Since a starts to appear from the position beyond the area mark SPa and reaches the position beyond the area mark SPb, it is possible to recognize that the biopsy needle K is not correctly inserted according to the guideline GL.

Of course, also in the case of the X-ray CT apparatus of this embodiment, not only the cross section perpendicular to the body axis of the subject M is photographed, but also the gantry G may be inclined by an angle TA, and a cross section obliquely inclined with respect to the body axis of the subject M may be used as a slice plane to be imaged. Also, when obtaining the area marks SPa and SPb, the inclination of the gantry G is also considered. It is necessary to consider the angle TA. In the case of the embodiment, the inclination angle TA of the gantry G
Is provided to the slice width area calculation and display unit 24, and the process of replacing each coordinate with the device coordinate system based on the tilt angle TA is performed by the slice width. It is configured to be performed by the area request display unit 24.

Thus, according to the apparatus of this embodiment,
Area marks SPa and SPb indicating the slice width area of the guideline GL existing within the slice thickness width Zd of the CT tomographic image superimposed and displayed on the guideline GL extend over the entire tip width Ka of the biopsy needle K over the entire slice thickness. Since this serves as a guide for guiding to a precise position, the biopsy needle can be more accurately and quickly inserted into the subject.

The present invention is not limited to the above embodiment, but can be modified as follows. (1) The apparatus of the embodiment has an X-ray CT configuration,
An I apparatus (magnetic resonance tomography apparatus) is a modification.

(2) In the embodiment, the angle calculation display unit 2
A laser beam irradiating means for irradiating the subject M with a laser beam pointing in a direction corresponding to the angles of determination AG1 and AG2 determined by step 1 is provided. If the longitudinal direction of the biopsy needle K is aligned with the laser beam, As a modified example, a device configured so that the needle meter K is correctly aligned with the piercing direction indicated by the guideline GL is mentioned.

(3) In the embodiment, the case where only one set of biopsy needle insertion point and tissue sampling point is specified and only one guide line is determined and displayed is described. A configuration may be possible in which a plurality of sets of biopsy needle insertion points and tissue sampling points can be designated and a plurality of guidelines can be obtained and displayed.

(4) In the above embodiment, the position (slice section) of the tomographic image is displaced by moving the tabletop. However, while the tabletop is fixed, the imaging system is connected to the body axis of the subject. , The position of the tomographic image may be displaced.

(5) In the other embodiment, both the area marks SPa and SPb and the intersection MP are superimposed and displayed on the CT tomographic image. However, the intersection MP is located at the middle point of the area marks SPa and SPb. , So the area mark SP
If a and SPb are displayed, the intersection point MP can be determined by visual examination to some extent even if the intersection point MP is not displayed.
An X-ray CT apparatus in which only a and SPb are superimposed and displayed on a tomographic image is given as a modification.

[0066]

As described in detail above, according to the tomography apparatus of the first aspect of the present invention, if the insertion point and the target point of the puncture needle in the subject are designated and input on the screen, the puncture can be performed. A line segment connecting the entry point and the target point is calculated and the line segment is superimposed and displayed on the tomographic image as a guideline when inserting the puncture needle. The insertion path can be accurately predicted based on the guidelines described above, so that the insertion path of the insertion needle will always be accurate, and the guidelines will be a guide when inserting the insertion needle. Piercing is performed promptly.

According to the tomography apparatus of the second aspect,
The intersection mark indicating the intersection between the tomographic image and the guideline is
As a guide for guiding the needle point of the puncture needle to an accurate position, the puncture needle is always superimposed and displayed on the tomographic image, so that the puncture needle can be more accurately and quickly inserted into the subject.

According to the tomography apparatus of the third aspect,
The slice width area of the guideline that exists within the slice thickness width of each tomographic image for confirming the insertion needle status is found as a guide to guide the needle tip of the insertion needle to an accurate position over the entire width of the slice thickness Since it is configured to be displayed, the insertion needle can be more accurately and quickly inserted into the subject.

According to the tomography apparatus of the fourth aspect,
Since the numerical value indicating the angle between the guideline and the preset reference axis is simultaneously displayed on the display monitor as a guide of the insertion direction of the insertion needle, the insertion needle can be more accurately and promptly inserted. It can pierce the subject.

According to the tomography apparatus of the fifth aspect,
Since the numerical value indicating the length of the guideline is displayed simultaneously on the display monitor as a guide to the depth of insertion of the insertion needle, the insertion needle can be inserted more accurately and promptly into the subject. it can.

[Brief description of the drawings]

FIG. 1 is a block diagram illustrating an overall configuration of an X-ray CT apparatus according to an embodiment.

FIG. 2 is a schematic perspective view showing an outline of tomography performed by the apparatus according to the embodiment.

FIG. 3 is a schematic front view showing an overview of tomography performed by the apparatus according to the embodiment.

FIG. 4 is a front view showing an input screen of a biopsy needle insertion point in the apparatus according to the embodiment.

FIG. 5 is a front view showing a screen for inputting a tissue sampling point in the apparatus according to the embodiment.

FIG. 6 is a front view showing a display screen of a guide line in the apparatus of the embodiment.

FIG. 7 is a front view showing a display screen during insertion of a biopsy needle in the apparatus according to the embodiment.

FIG. 8 is a front view showing a gantry tilting state in the apparatus of the embodiment.

FIG. 9 is a flowchart showing the progress of tissue collection by a biopsy needle in the example.

FIG. 10 is a block diagram illustrating an overall configuration of an X-ray CT apparatus according to another embodiment.

FIG. 11 is a front view showing a display screen of a guide line in another embodiment device.

FIG. 12 is a schematic diagram showing a slice thickness width in a subject to be imaged;

FIG. 13 is a schematic diagram showing a biopsy needle insertion state in another embodiment device.

FIG. 14 is a schematic diagram showing a state of movement of a needle point of a biopsy needle on a screen as a biopsy needle insertion operation progresses in another embodiment device.

FIG. 15 is a schematic perspective view showing an outline of tomography by a conventional apparatus.

FIG. 16 is a front view showing a display screen during biopsy needle insertion in a conventional apparatus.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 ... Top plate 2 ... X-ray tube 3 ... X-ray detector 14 ... Image reconstruction part 16 ... Display monitor 17 ... Mouse 18 ... Guideline finding display part 20 ... Intersection finding display part 21 ... Angle finding display part 22 ... Length calculation display section 24 ... Slice width area calculation display section A ... Biopsy needle insertion point AG1, AG2 ... Calculation angle B ... Tissue sampling point D ... Calculation length GL ... Guideline K ... Biopsy needle M ... Subject MP ... intersection mark SPa, SPb ... area mark

Claims (5)

[Claims] In a tomographic apparatus configured to display a tomographic image of a site where an insertion needle is inserted in a subject in real time on a display monitor, the insertion point and the target point of the insertion needle in the subject are set tomographically. Screen input means for specifying and inputting on the screen of the display monitor on which the image is projected, and a line connecting the insertion point and the target point specified by the screen input means are determined, and the determined line is inserted. A tomographic imaging apparatus comprising: a guideline obtaining and displaying unit that superimposes and displays a tomographic image as a guideline when inserting a needle. 2. The tomographic apparatus according to claim 1, wherein
A tomographic imaging apparatus including an intersection finding display unit that sequentially finds an intersection between a tomographic image and a guideline following a positional displacement of the tomographic image and superimposes and displays an intersection mark indicating the found intersection on the tomographic image. 3. The tomography apparatus according to claim 1, wherein slice width areas corresponding to both ends of the guide line existing within the slice thickness width of the tomographic image are sequentially determined following the positional displacement of the tomographic image. A tomography apparatus that includes a slice width area calculation display unit that outputs a slice width area of a determined guideline on a tomographic image. 4. The tomography apparatus according to claim 1, wherein an angle between the guide line and a preset reference axis is calculated, and a numerical value indicating the calculated angle is displayed on a tomographic image. Tomography apparatus provided with angle finding display means for simultaneously displaying on a display monitor for use. 5. The tomography apparatus according to claim 1, wherein a length of the guide line is determined, and a numerical value indicating the determined length is simultaneously displayed on a display monitor for displaying a tomographic image. A tomography apparatus including a length finding and displaying means for performing the operation.